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This tool can assist Ministries of Health (MoHs), key partners and stakeholders to carry out an evaluation of the quality of care provided at hospital level, to identify key areas that need to be improved, and to develop specific action plans. When the tool is used for country-wide assessment, an adequate sample of hospitals should be assessed. It can also be used in a single facility for internal audit purposes. The tool adopts a participatory approach that facilitates wide involvement and sustained improvement of practice.